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Open AccessJournal ArticleDOI

Insights into the Management of Papillary Microcarcinoma of the Thyroid.

Akira Miyauchi, +2 more
- 01 Jan 2018 - 
- Vol. 28, Iss: 1, pp 23-31
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TLDR
Interestingly, older patients with low-risk PMCs are the best candidates for active surveillance, and they are most unlikely to grow in older patients (≥60 years).
Abstract
Background: Rapid increases in the incidence of thyroid carcinoma with stable mortality rates from thyroid carcinoma have been reported from many countries, and these increases are thought to be due mostly to the increased detection of small papillary thyroid carcinomas (PTCs), including papillary microcarcinomas (PMCs; i.e., PTCs ≤10 mm). Some researchers have suggested that small PTCs have been overdiagnosed and overtreated. In Japan, the active surveillance of patients with low-risk PMCs was initiated by Kuma Hospital (1993) and Tokyo's Cancer Institute Hospital (1995) based on the extremely higher incidences of both latent thyroid carcinomas in autopsy studies and small PTCs detected in mass screening studies using ultrasound examinations compared to the prevalence of clinical thyroid carcinomas. Methods: The above two institutions' data are summarized regarding the active surveillance of low-risk PMCs, and future prospects for their management are discussed. Results: At 10-year observations in the Ku...

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Citations
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Journal ArticleDOI

High Serum TSH Level Is Associated With Progression of Papillary Thyroid Microcarcinoma During Active Surveillance.

TL;DR: Sustained elevation of serum TSH levels during active surveillance is associated with PTMC progression, and maintaining a low-normal TSH range with levothyroxine treatment during active Surveillance of PTMC might be considered in future studies.
Journal ArticleDOI

Patient Experience of Thyroid Cancer Active Surveillance in Japan.

TL;DR: Levels of cancer worry reported by patients under active surveillance decreased over time, and patients expressed satisfaction with their disease management decision, suggesting that the possibility of cancerorry should not be viewed as prohibitive to successful active surveillance in thyroid cancer.
Journal ArticleDOI

The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

TL;DR: Department of Pathology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Shanghai, China, and Department of Hospital Pathological, College of medicine, The Catholic University of Korea, Seoul, Korea.
References
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Journal ArticleDOI

Increasing incidence of thyroid cancer in the United States, 1973-2002.

TL;DR: In this article, the authors examined trends in thyroid cancer incidence, histology, size distribution, and mortality in the United States, concluding that the increasing incidence of thyroid cancer is primarily due to the increased detection of small papillary cancers.
Journal ArticleDOI

Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013.

TL;DR: Among patients in the United States diagnosed with thyroid cancer from 1974-2013, the overall incidence of thyroid cancer increased 3% annually, with increases in the incidence rate and thyroid cancer mortality rate for advanced-stage papillary thyroid cancer.
Journal ArticleDOI

Current Thyroid Cancer Trends in the United States

TL;DR: Analysis of secular trends in patients diagnosed with thyroid cancer, 1975 to 2009, using the Surveillance, Epidemiology, and End Results (SEER) program and thyroid cancer mortality from the National Vital Statistics System suggests an ongoing epidemic of thyroid cancer in the United States.
Journal ArticleDOI

Korea's Thyroid-Cancer “Epidemic” — Screening and Overdiagnosis

TL;DR: In 2011, the rate of thyroid-cancer diagnoses in the Republic of Korea was 15 times that observed in 1993, yet thyroid- Cancer mortality remains stable — a combination that suggests that the problem is overdiagnosis attributable to widespread thyroid- cancer screening.
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